Ischemic heart disease is the commonest cause of morbidity and mortality in patients with chronic renal failure (CRF). While there are several known risk factors associated with coronary artery disease, none are very sensitive or specific for the detection of coronary artery lesions. The diagnostic modalities which can detect coronary artery lesions tend to be expensive and/or invasive. The advent of electron beam computed tomography (EBCT) provides a relatively diagnostic imaging modality that may prove useful as a screening tool in the detection and monitoring of coronary artery disease in this high-risk group.